The midwife/home birth/virtue of crunchiness/feminist debate has surfaced again, and the talk seems to be centered (again) on the choice a woman makes between home birth (not very safe) and hospital birth (much safer, but still prone to complications). This debate never fails to get a rise out of me, because I don’t believe that a natural home birth with a midwife and a medicated hospital birth with an OB should be a choice that pregnant women have to make. I chose to have Monkey in a hospital because I believed that was best for him and me, and I’d make the same decision again. But I’d choose to deliver with the assistance of a certified nurse midwife instead of an OB. I’d listen to my nurse when she told me to wait longer before heading to the hospital, so that I could do most of my laboring in the comfort of my own home. I’d not have let them break my water to *speed things up*. And I’d try to deliver without the assistance of an epidural. (I wasn’t in pain and I stopped throwing up every minute, but I itched like a mutherfucker after they shot me up, leading to 7 hours of tossing and turning and scratching while hooked up to a machine that wouldn’t stop beeping. Try and get some sleep before it’s time to push… yeah right.)
Anyhow, I just read Kate Clancy’s take, a good source of information for individuals on either end of the spectrum, or those who are simply trying to dig through the noise. Also, if anyone’s interested, here’s what I wrote a few months ago:
I’m not one of those granola women who avoided hospitals and medical interventions during labor. But I was (and still am) a big believer that birth is a natural process, which sometimes gets treated like an illness by the medical profession. I chose to give birth to Monkey in a hospital, in case – God forbid – something happened, but I made it clear that I wanted Monkey’s birth to be as natural as possible. As a result of my preparedness and support system (a doula), interventions weren’t proposed until my labor stalled and I started asking questions. And I was offered an epidural only after muttering my safe word to Hubby (since breaking my water also led to hell breaking lose throughout my body). In spite of the fact things didn’t go the way I planned, I was clearly in charge of how I was treated during labor. And I like being in charge.
After Monkey was born and the doula left, that “in charge” feeling quickly faded. Monkey had trouble clearing out all of the fluid in his lungs and wasn’t crying as loudly as the nurses would have liked. So I barely had a chance to let him latch on to nurse before they took him away. For most of his first hours, I wasn’t allowed to hold my baby boy. Instead, he was in a crib surrounded by nurses and Hubby, where I could barely see him. It was upsetting, and I now wonder if this separation contributed to problems breastfeeding and postpartum depression. The next couple of days of my stay, I was bombarded by doctors, nurses, and a plethora of specialists, each directing me how to best take care of my baby, and some of whom were quite rude. In spite of their helicoptering and my constant requests, I was allowed to leave the hospital without being given the all-important TDaP vaccine. To say the least, I wasn’t impressed with the hospital experience at all, post-Monkey’s birth.
This past weekend, Hubby and I watched a documentary called “The Business of Being Born“, a scathing assessment of what was referred to as the birthing industry. I was uncomfortable watching it, partly due to the fact that Ricki Lake give birth in a bath tub (the images from which may never be wiped from my memory), and partly because home births were pushed so strongly. I believe properly-trained certified nurse midwives can direct many births, without the use of heavy medical interventions that often drive up the cost of delivery. And I don’t like how often cesarean sections occur, especially when due to convenience rather than medical necessity. But do we really want to go back to a time when women and newborn babies lacked the medical treatment they need?
IMO, there’s a more realistic solution that should be considered. We should depend more on certified nurse midwives, in hospitals, for uncomplicated pregnancies. And more hospitals should employ doulas, or some sort of support personnel, to guide women through the birthing process AND postpartum period. These measures are common in other countries, which (according to the documentary) have better rates of maternal and baby survival at much less cost. Furthermore, studies in the US have determined that the presence of a doula is correlated with less intervention and lower rates of cesarean section (ie, lower cost). In the midst of rising health care costs, this might be a good time to consider a safe, practical, and cost-effective middle ground for childbirth, if only we can remember how to compromise.